Hiding Veins

[choijk]

Dear Friends,
I was wondering if there are any tips that you may be able to offer my father? He is transfusion dependent (1-2 pints every 2 weeks) and today, his veins were put to the test! He was poked at least 4 times before they were able to find a vein that would allow him to receive his transfusion. Any tips on how to ease the pain or how to make the transfusions easier? And, this is just for my own curiosity, how bad (how much does it hurt) when being poked with needles? I know its a stupid question and the answer is that, of course it hurts, but I just have to know. It pains me to see my father in pain. I know this pain is not pain at all in the grand scheme of things but I guess I am just over protective....
Thank you for your help

[Ger]

Don has been told to drink some extra water before he needs a blood draw etc.
also many times he will do a half dozen "push-ups" braces his hands on the kitchen counter and does a simulated push-up. Or at times I've seen him use a small footstool (3-5 lbs.)we have for a weight and lift that several times. I does seem to help when they try to find his veins.

Geri

[Neil Cuadra]

I too drink lots of fluids before a blood draw, and that helps.

Another tip: Notice where they most often find a good vein. Chances are it'll be the same place most of the time. Then tell the nurse or blood draw technician ahead of time, rather than letting them hunt and poke in the wrong place.

For some reason, my left arm has much better veins than my right arm, even though I'm right-handed, so I've learned to tell them to look there.

[Birgitta-A]

Hi Choijk,
Perhaps your father could have a port-a-cath?

A port-a-cath (port) is an implanted device through which RBC:s may be infused and blood may be withdrawn without repeated needle sticks. The port is inserted in his upper chest wall. It is about the size of a quarter, only thicker, and will show only as a bump underneath the skin. There are several benefits to having a port:

No need to find a vein every time he receives a transfusion. A special needle fits right into the port, so all he feels is the stick—not the poking, prodding, and false tries in his arm.

Getting blood for blood tests can usually be done through the port, decreasing the number of times he needs to have a vein "stuck
Kind regards
Birgitta
68 yo, MDS interm-1 dx May 2006, transfusion dependent, Desferal 4 days/month, port-a-cath since Jan 2007, Neupogen injections 2 days/week, Prednisolone 2,5 mg/day

[Neil Cuadra]

As Birgitta-A points out, a subcutaneous port is an option. They have benefited many patients who needed frequent transfusions or blood draws.

They aren't without risks, however. In addition to the small dangers of minor surgery, having a port can put the patient more at risk for infection.

If you want to look into this option, you should definitely discuss it with your father's doctors.

[Margie]

I am new to the site; hope this is not an incorrect response somehow. I am also dependent on transfusions - 2 pints every 3-4 weeks. The nurses are different from time to time and all have their own favorite vein, usually in the hand - one nurse uses the vein toward the side of the hand above the thumb. I have never had a problem with pain from the iv line being put in. They always numb the site an instant before they insert the needle. This stings very little and makes the needle insertion painless. Even if they occasionally have to make more than one attempt at a vein, it is not a big deal done in this manner.

[Kitty]

I get transfusions every 6/7 weeks. The nurses at the Monterey Hospital, CA, first put warm, wet pads on my arm before inserting the needle. They told me the warmth expands the veins and it makes it easier and less painful.

Now they do it on the vein a little above my wrist. Hard to explain but is the vein that ends in the thumb. It did not hurt at all.

The first time they used the vein on my hand and it was painful. One doctor told me that was because there are lots of nerves on the hand, and if they get close to one of them then it hurts. But, even then, the pain is not bad, just unconfortable. So, now I told them my hands are off limits.

You can also ask for a more experience nurse if your Dad has veins that are difficult to find. Experience makes a big difference. I requested that and they did not mind it at all.

I hope the next one goes well.

Kitty

[Chirley]

Hi, the nurses who insert my iv are very good because they do it all the time. Sometimes if I'm cold or dehydrated they have a little bit of trouble and have 2 or 3 goes but even when they have to prod around it doesn't really hurt very much. They don't use local anaesthetic and I don't really think it's necessary unless your veins are really bad or you are a little bit needle phobic. I am very grateful that I don't have fear of needles. On the other hand SPIDERS!!!! Chhirley

[choijk]

Thank you all for the helpful advice and suggestions! I will definetly pass this info to my dad and hopefully the next visit will be a lil more pleasant! God Bless everyone!!!

[Neil Cuadra]

If you have a choice, ask to have the most experienced technician or nurse draw the blood. I have learned first-hand that the "specialists," the ones who draw blood many times per day, do a better job than those who draw blood only occasionally. There is less discomfort, and more chance of success on the first try, when you have an "expert."

I don't know what they do differently, but there must be some skill and technique to it that makes them better from practice.

[Tom M]

Hi June,....As Neil has said, ask for the most experienced tech. It makes a big difference in lowering the number of attempts. I've had nurses ruin perfectly good sticks due to lack of experience. They often apologize and I tell to get me someone experienced. I do not mean to hurt their feelings, but I cannot afford to be getting stuck time after time and having good veins blown because they only do a couple of sticks per day.

As for pain, it depends on the person's tolerance and the location of the stick. The tech also makes a big difference, along with the speed of the needle insertion. A quick stick hurts less than a slow one, at least that is my experience. Mild restriction, warmth, and letting the arm hang down, drinking fluids an hour or so before, and even some light tapping on the area to be stuck can expose an otherwise hidden vein. A person's physical makeup is the biggest factor. Some people have what are called "sewer lines", large exposed veins just under the surface of the skin, while others have small veins hidden under many layers of tissue.

I hope this helps.

[Wendy Beltrami]

I have a few more things to offer with regard to finding those hiding veins. Grant has been transfusion dependent for almost 2 years now and refuses to have a port so we know all the tricks.

As everyone else has mentioned... drink a lot of water prior. Hanging your arm down off the side of the bed/chair for a while also is very helpful. Ask for a warm towel to wrap your arm in for a few minutes. The light "tapping" on the vein is supposed to release histamines to "plump" the vein and yet... I'm guessing most people take transfusion "pre meds" of benedryl and tylenol. Everyone knows that benedryl is an ANTI-histamine.... so... although it's hard to know whether it really makes a difference or not.... Grant doesn't take his pre-meds until the IV is already in.

He also tries to lift small dumbells every day to help pump up those arm veins.

The most valuable thing is finding that favorite person to do the IVs. They don't like missing a stick any more than the patient likes it. If we encounter someone new I always make it very clear that "Grant is a tough stick", giving the person the chance to turn us over to a more experienced nurse or phlebotomist. Two tries is all anyone gets. After that, ask for "the best person you've got".

We have used peds nurses, ER nurses and even nurse anesthetists in our hospital.

We notice that Grant will go for months and months with no problems and then have a run of difficulties where good veins are nowhere to be found.
It's really kinda' strange.

Hope that helps..
Wendy/mom to Grant
Diagnosed 12/4/98 (AAACK! 9 years!)

[celebrations]

Hi Kitty,
tried to reach you on the forum of the mds-foundation, there I wrote you some private mails, because I am trisomy 8 like you are and this is quite rare. You have never answered so far, so I presume you did not get my mails all over from my German adress. - I know two other persons in that forum who are RARS/trisomy 8, both are transfusion dependant.
I am not yet, EPO still works with me and keeps my HGB up (only between 10,0 and 10,4)...bur I would appreciate very much to get in touch about this trisomy 8. What have your docs told you about? It makes us intermediate 1, I know, it is not a good one, though better as abnormalities in 7 for instance.
Can you answer now,
or anybody else who reads one of her posts might tell her, that I urgently want to get in contact with her...


Thank you, Bergit

Besides, are there any other 8s out here? Give me a post.

[Neil Cuadra]

Bergit,

If Kitty doesn't spot your post here, you can send her email or a Private Message from her Marrowforums profile page.

[usaf1125]

Get a Port installled. I have a "Bard Port" with Groshong Catheter. This is how I get my infussion, 2 units ever 2 weeks. Very simple procedure done in day surgery. Please ask your doctor it will save a lot of pain. Good luck.